结合免疫组化标记物分析超声造影对乳腺癌预后评估的价值  

The value of contrast-enhanced ultrasound combined with immunohistochemical markers in the prognostic evaluation of breast cancer

作　　者：陈小琴 翁细金 孙海琴 陈利民 CHEN Xiaoqin;WENG Xijin;SUN Haiqin;CHEN Limin(Department of Ultrasound,Wenzhou Central Hospital,Wenzhou 325000,China)

机构地区：[1]温州市中心医院超声科,浙江温州325000

出　　处：《温州医科大学学报》2022年第4期300-304,共5页Journal of Wenzhou Medical University

摘　　要：目的:分析与免疫组化标记物预后参数相关的乳腺癌超声造影特征,探讨超声造影对乳腺癌预后评估的价值。方法:于2019年1月至2020年12月,选择温州市中心医院收诊的150例乳腺肿块患者作为研究对象,所有患者均接受常规超声及超声造影检查,以手术和(或)穿刺活检病理为金标准,比较超声造影与常规超声诊断乳腺癌的敏感度、特异度、准确率、阳性预测值、阴性预测值,分析乳腺癌患者超声造影特征与p53、Ki-67、雌激素受体(ER)、孕激素受体(PR)表达的相关性。结果:超声造影在乳腺癌诊断中的敏感度、特异度、准确率、阳性预测值、阴性预测值均高于常规超声(P<0.05)。乳腺恶性肿块的超声造影强化程度高于乳腺良性肿块患者(P<0.05),乳腺恶性肿块造影剂开始增强时间、达峰时间、峰值消退时间均短于乳腺良性肿块患者(P<0.05)。乳腺癌患者超声造影图像中血流灌注缺损与p53、Ki-67阳性表达呈正相关(r=0.814、0.839,P<0.05),与ER、PR阳性表达呈负相关(r=-0.780、-0.769,P<0.05);造影后肿瘤范围较造影前扩大与p53、Ki-67阳性表达呈负相关(r=-0.820、-0.841,P<0.05),与ER、PR阳性表达呈正相关(r=0.803、0.785,P<0.05);高增强与p53、Ki-67阳性表达呈正相关(r=0.789、0.773,P<0.05),与ER、PR阳性表达呈负相关(r=-0.754、-0.781,P<0.05)。结论:超声造影能提高乳腺癌术前诊断的准确性,超声造影部分特征性表现与乳腺癌免疫组化指标存在密切关联,反映了乳腺癌的生物学特性,可作为术前无创评估乳腺癌预后的参考指标。Objective:To investigate the characteristics of contrast-enhanced ultrasound(CEUS)related to the prognostic parameters of immunohistochemical markers in breast cancer,and to explore the value of CEUS in the prognosis evaluation of breast cancer.Methods:From January 2019 to December 2020,150 patients with breast masses in Wenzhou Central Hospital were selected as subjects.All patients were examined by conventional ultrasound and contrast-enhanced ultrasound.The gold standard was the pathological diagnosis of surgical and/or puncture biopsy.The expressions of p53,Ki-67,estrogen receptor(ER)and progesterone receptor(PR)in patients with breast cancer and benign breast masses were detected by immunohistochemical staining.The correlation between the positive expression of p53,Ki-67,ER and PR and the characteristics of contrast enhanced ultrasound in breast cancer patients were analyzed.Results:The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of contrast-enhanced ultrasound in the diagnosis of breast cancer were significantly higher than those of conventional ultrasound(P<0.05).The peak intensity of breast cancer patients was higher than that of benign breast masses(P<0.05),the time of onset enhancement,the time to peak and the peak extinction time of breast cancer patients were shorter than those of benign breast tumor patients(P<0.05).Blood perfusion defect in contrast-enhanced ultrasound images of breast cancer patients was positively correlated with the positive expression of p53 and Ki-67(r=0.814,0.839,P<0.05),but negatively correlated with the positive expression of ER and PR(r=-0.780,-0.769,P<0.05).The tumor range after contrast was larger than that before,and it was positively correlated with the negative expression of p53 and Ki-67(r=-0.820,-0.841,P<0.05),but positively correlated with the positive expression of ER and PR(r=0.803,0.785,P<0.05).The high peak enhancement was positively correlated with the positive expression of p53 and Ki-67(r=0.789,0.773,P<0.05),and it

关 键 词：乳腺癌 超声造影 免疫组化 雌激素受体 孕激素受体 p53 KI-67 

分 类 号：R445.1[医药卫生—影像医学与核医学]